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Impact of Impaired Pancreatic β-Cell Function on Cardiovascular Prognosis in Heart Failure Patients Without Diabetes Mellitus

Background: Insulin resistance as assessed using homeostasis model assessment ratio (HOMA-R) is associated with latent myocardial damage in apparently healthy subjects in health check. Meanwhile, diabetes mellitus (DM) is an unfavorable prognostic risk factor in patients with heart failure (HF). We...

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Autores principales: Narumi, Taro, Watanabe, Tetsu, Kato, Shigehiko, Tamura, Harutoshi, Nishiyama, Satoshi, Takahashi, Hiroki, Arimoto, Takanori, Shishido, Tetsuro, Watanabe, Masafumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Circulation Society 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889481/
https://www.ncbi.nlm.nih.gov/pubmed/33693147
http://dx.doi.org/10.1253/circrep.CR-19-0033
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author Narumi, Taro
Watanabe, Tetsu
Kato, Shigehiko
Tamura, Harutoshi
Nishiyama, Satoshi
Takahashi, Hiroki
Arimoto, Takanori
Shishido, Tetsuro
Watanabe, Masafumi
author_facet Narumi, Taro
Watanabe, Tetsu
Kato, Shigehiko
Tamura, Harutoshi
Nishiyama, Satoshi
Takahashi, Hiroki
Arimoto, Takanori
Shishido, Tetsuro
Watanabe, Masafumi
author_sort Narumi, Taro
collection PubMed
description Background: Insulin resistance as assessed using homeostasis model assessment ratio (HOMA-R) is associated with latent myocardial damage in apparently healthy subjects in health check. Meanwhile, diabetes mellitus (DM) is an unfavorable prognostic risk factor in patients with heart failure (HF). We examined the impact of pancreatic β-cell dysfunction on clinical outcomes in HF patients without DM. Methods and Results: This study enrolled 312 HF patients without DM. Pancreatic β-cell dysfunction was defined as HOMA-β <30%. A total of 108 patients (35%) had β-cell dysfunction. Plasma brain natriuretic peptide was higher in patients with pancreatic β-cell dysfunction compared with those without (625.2 vs. 399.0 pg/mL, P<0.001). On Kaplan-Meier analysis, a significantly higher cardiovascular events rate was observed in patients with pancreatic β-cell dysfunction (log-rank test, P=0.001), but there was no significant difference between patients with and without insulin resistance. On Cox hazard analysis, pancreatic β-cell dysfunction was independently associated with cardiovascular events after adjustment for confounding factors (HR, 1.58; 95% CI: 1.02–2.45), whereas insulin resistance was not associated with cardiovascular events. Conclusions: Pancreatic β-cell dysfunction, but not insulin resistance, was associated with unfavorable outcome in HF patients without DM.
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spelling pubmed-78894812021-03-09 Impact of Impaired Pancreatic β-Cell Function on Cardiovascular Prognosis in Heart Failure Patients Without Diabetes Mellitus Narumi, Taro Watanabe, Tetsu Kato, Shigehiko Tamura, Harutoshi Nishiyama, Satoshi Takahashi, Hiroki Arimoto, Takanori Shishido, Tetsuro Watanabe, Masafumi Circ Rep Original article Background: Insulin resistance as assessed using homeostasis model assessment ratio (HOMA-R) is associated with latent myocardial damage in apparently healthy subjects in health check. Meanwhile, diabetes mellitus (DM) is an unfavorable prognostic risk factor in patients with heart failure (HF). We examined the impact of pancreatic β-cell dysfunction on clinical outcomes in HF patients without DM. Methods and Results: This study enrolled 312 HF patients without DM. Pancreatic β-cell dysfunction was defined as HOMA-β <30%. A total of 108 patients (35%) had β-cell dysfunction. Plasma brain natriuretic peptide was higher in patients with pancreatic β-cell dysfunction compared with those without (625.2 vs. 399.0 pg/mL, P<0.001). On Kaplan-Meier analysis, a significantly higher cardiovascular events rate was observed in patients with pancreatic β-cell dysfunction (log-rank test, P=0.001), but there was no significant difference between patients with and without insulin resistance. On Cox hazard analysis, pancreatic β-cell dysfunction was independently associated with cardiovascular events after adjustment for confounding factors (HR, 1.58; 95% CI: 1.02–2.45), whereas insulin resistance was not associated with cardiovascular events. Conclusions: Pancreatic β-cell dysfunction, but not insulin resistance, was associated with unfavorable outcome in HF patients without DM. The Japanese Circulation Society 2019-05-29 /pmc/articles/PMC7889481/ /pubmed/33693147 http://dx.doi.org/10.1253/circrep.CR-19-0033 Text en Copyright © 2019, THE JAPANESE CIRCULATION SOCIETY This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original article
Narumi, Taro
Watanabe, Tetsu
Kato, Shigehiko
Tamura, Harutoshi
Nishiyama, Satoshi
Takahashi, Hiroki
Arimoto, Takanori
Shishido, Tetsuro
Watanabe, Masafumi
Impact of Impaired Pancreatic β-Cell Function on Cardiovascular Prognosis in Heart Failure Patients Without Diabetes Mellitus
title Impact of Impaired Pancreatic β-Cell Function on Cardiovascular Prognosis in Heart Failure Patients Without Diabetes Mellitus
title_full Impact of Impaired Pancreatic β-Cell Function on Cardiovascular Prognosis in Heart Failure Patients Without Diabetes Mellitus
title_fullStr Impact of Impaired Pancreatic β-Cell Function on Cardiovascular Prognosis in Heart Failure Patients Without Diabetes Mellitus
title_full_unstemmed Impact of Impaired Pancreatic β-Cell Function on Cardiovascular Prognosis in Heart Failure Patients Without Diabetes Mellitus
title_short Impact of Impaired Pancreatic β-Cell Function on Cardiovascular Prognosis in Heart Failure Patients Without Diabetes Mellitus
title_sort impact of impaired pancreatic β-cell function on cardiovascular prognosis in heart failure patients without diabetes mellitus
topic Original article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889481/
https://www.ncbi.nlm.nih.gov/pubmed/33693147
http://dx.doi.org/10.1253/circrep.CR-19-0033
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